What is Brain Injury?

What is Brain Injury?

The human brain controls everything we do. It keeps us alive by regulating breathing, circulation, digestion, and the immune system. The brain controls abilities such as movement, memory, speech, vision, hearing, making decisions, and our ability to get organized and get things done. It is through the brain that we are able live, experience emotions, and express ourselves. The brain controls everything we say, do, think, and feel.

Despite its encircling fortress of bone (the skull), the brain is especially vulnerable to physical insult and injury, which may affect its different functions and result in a number of temporary or permanent impairments.

Types of Brain Injury

Brain injury refers to the occurrence of an insult to the brain, causing temporary or permanent damage. It is often described as either traumatic or acquired, depending on the underlying cause.

An Acquired Brain Injury (ABI) is an injury to the brain that is not hereditary, congenital, degenerative or induced by birth trauma. Acquired brain injuries are caused by conditions including strokes, tumors, blood clots, seizures, infections (encephalitis, meningitis), anoxia (lack of oxygen to the brain), metabolic disorders, abuse of illegal drugs and/or neurotoxic poisoning.

A Traumatic Brain Injury (TBI) is defined as a jolt or blow to the head or a penetrating head injury that disrupts the normal functioning of the brain. It is an insult to the brain caused by an external physical force. Causes of traumatic brain injuries include motor vehicle accidents, falls, gunshot wounds, sports-related injuries, military actions, physical violence, child abuse, shaken baby syndrome and other injuries caused by trauma.

According to the CDC, more than 2 million Americans a year sustain a TBI. Falls are the number one cause of TBIs, accounting for 40%, with rates highest in those over 65 years of age. Men have higher rates of TBI than women, and are nearly three times as likely to die of a TBI.

Severity of Brain Injury

Brain injury severity can range from mild to severe, depending on a number of factors. Severity is traditionally based on duration of loss of consciousness, coma rating scale score, post-traumatic amnesia (PTA), and brain imaging results.

A mild brain injury may be temporary; causing brief loss of consciousness, headaches, some confusion, nausea, and PTA of less than an hour or so.

In a moderate brain injury, symptoms may last from 1-24 hours and are usually more pronounced.

With a severe brain injury, the individual may suffer life-changing and debilitating problems. People who are in a coma or a minimally responsive state may remain dependent on the care of others for the rest of their lives.

Although brain injuries are given an initial severity rating, this may not accurately reflect the impact of the injury on the individual and their family’s lives.

Impact on the Individual

A brain injury, whether acquired or traumatic, can have a devastating impact on the affected individual. It may result in impairments of cognitive abilities, physical functioning, communication abilities, and/or behavioral and emotional functioning. Some of these problems include:

Impact on the Family

Brain injury affects not just the individual, but also the family, loved ones, close friends, and other social networks of the individual. Family members may experience:

Feelings of isolation and helplessness

Restricted independence

Loss of emotional support

Frustration due to lack of knowledge

Adjustment to changes in their loved one and role in the family

Financial constraints

Caregiver burden with risk of burnout

Family members are extremely important members of the health care team; providing comfort, reassurance, and support to the person with brain injury. The active participation and involvement of family members, caregivers, friends, and co-workers can significantly help the individual with brain injury successfully return home and to the community.

Brain Injury Rehabilitation

Brain injury rehabilitation is a marathon, not a sprint. Recovery from brain injury is a process that takes time. In recent years, the specialty of neurological rehabilitation has advanced in its understanding of ways to encourage and maximize recovery. The healthcare team will use all available knowledge and techniques while caring for your loved one. While the most dramatic recovery often happens in the first year, progress is always possible as the brain continues to heal, learn, and practice. It’s important to never give up and keep working toward your goals.

Role of the Speech-Language Pathologist

Speech-language pathologists (SLPs) are rehabilitation specialists responsible for the evaluation and treatment of deficits related to speech, language, swallowing, and cognitive-communication in individuals with brain injury.

An individualized treatment plan is developed after the initial evaluation. The SLP treatment program will vary depending on the stage of recovery, but will always focus on increasing independence in everyday life.

In the early stages of recovery, SLP treatment focuses on:

Eliciting generalized responses to sensory stimulation

Teaching family members how to interact with the loved one

As an individual becomes more aware, SLP treatment focuses on:

Reducing confusion

Maintaining attention for basic activities

Orienting the person to the date, where he or she is, and what has happened

Later on in recovery, SLP treatment focuses on:

Finding ways to improve memory

Learning strategies to improve executive functioning and social skills

5 Things to Remember about Brain Injury Rehabilitation

No two brain injuries are alike. Treatment and rehabilitation will vary according to the type of injury, deficits and needs of each individual.

‘More’ does not mean ‘better’. Therapy should be intensive; however it will only be effective if it is functional and meaningful for the individual.

Restore and compensate. Brain injury rehabilitation should focus on regaining lost skills as well as learning new ways to compensatefor abilities that have been permanently changed because of the injury.

Independence matters most. The ultimate goal of rehabilitation should be to help individuals progress to the most independent level of functioning possible; to restore a sense of normalcy and help re-integrate them to the community.

You are not alone. This is the most important statement that individuals and family members of those with a brain injury should remember. There are millions of others who have gone through the same thing you have. Don’t be afraid to ask questions, seek support, get involved and participate in the rehabilitation process. Your involvement can make all the difference!

For more sites with valuable information on brain injury, visit the Brain Injury resources page.

Guest Blogger Bio

Rinki Varindani Desai, M.S.,CCC-SLP is a medical speech-language pathologist. She is the creator/administrator of the Medical SLP Forum and co-author of the Dysphagia Therapy app. She is currently pursuing Board Certification as a Specialist in Swallowing and Swallowing Disorders (BCS-S) and Certification as a Brain Injury Specialist (CBIS). Follow her #MedSLP updates on Facebook, Twitter, and www.rinkislp.com.

One Comment

Lily Estoppey
February 9, 2016 at 8:26 pm

Very well explained, detailed. I particularly appreciated it as it is the first time in a decade that I find sensitive explanations to so many of what my husband has been suffering in this decade. Thanks.

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